Osteoarticular Tuberculosis-A Three Years’ Retrospective Study
Introduction: Extra pulmonary TB can be encountered in various organ systems, like lymph nodes, serous cavities, genitourinary tract, skeletal. Musculoskeletal TB can cause significant functional impairment. The clinical symptoms are variable, pain and swelling being common symptomatology. Inve...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2013-10-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/3467/23-%206859_E(%20_%20)_PF1(%20_%20)_F(H)_PF1(H)_PF1(PUH)_PF2(PUH)_PFA(P).pdf |
| Summary: | Introduction: Extra pulmonary TB can be encountered in
various organ systems, like lymph nodes, serous cavities,
genitourinary tract, skeletal. Musculoskeletal TB can cause
significant functional impairment. The clinical symptoms are
variable, pain and swelling being common symptomatology.
Investigations for suspected cases include radiological imaging,
histopathological examination, bacteriological examination, and
polymerase chain reaction.
The mainstay of treatment is multidrug antitubercular
chemotherapy.
Aim: To study the cases of osteoarticular TB diagnosed on
biopsy, to analyse the various microscopic patterns, results
of microbiological investigations, correlate the clinical and
radiological features and the response to ATT.
Setting and Designs: A teaching tertiary medical institute in
North India in catchment area, where prevalence of tuberculosis
is high. A retrospective study of cases with a biopsy diagnosis
of bone and/joint TB, retrieved from Histopathology section of
Department of Pathology of the tertiary institute.
Material and Methods: The study was retrospective and the
data was collected for the preceding 3 years. The cases were
retrieved from the records of the department of Pathology. A total
of 16 cases were diagnosed as/suspected to be tuberculosis
of bones and/joints. The clinical information were noted from
the case files. Results of laboratory investigations along with
relevant microbiologic investigations were noted. The biopsy
samples were processed according to protocol. Ziehl–Neelsen
stain to detect tubercle bacilli and PAS stain to rule out fungal
infection were done. Microscopic features were noted.
Results and Conclusion: Sixteen cases with a diagnosis of bone
and/joint tuberculosis were found. The average age was 23.6
years. The most common presentation was pain and swelling.
Knee joint was most commonly involved (7 cases) followed
by spine and ankle (3 each). All the cases showed epithelioid
granulomas which was necrotising in 11. AFB positivity was
found only in 4 cases. ATT was started in 12 cases with a good
response.
It is important to suspect osteoarticular TB clinically and
investigate accordingly. In resource poor setting, study of biopsy
material can aid in diagnosis, further guiding the management. |
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| ISSN: | 2249-782X 0973-709X |